Role of transurethral resection of the prostate in the management of prostate cancer

Abstract

Introduction: Prostate cancer is the second most diagnosed cancer in men, after lung cancer. The gold standard procedure in prostate cancer (PCa) diagnosis is the ultrasound guided prostate biopsy. Transurethral resection of the prostate (TURP) used in solving the bladder outlet obstruction, can have a role in detection of PCa. The aim of this retrospective study is to examine the role of transurethral resection of the prostate in the diagnosis and therapy of prostate cancer. Materials and methods: At the Urology Clinic of Targu Mures we performed a total of 474 TURP over a two year period (2011)(2012)(2013). The patients had a mean age of 71.857 years, and the indications were PCa with bladder outlet obstruction or bladder outlet obstruction with unknown causes but some with suspicion of PCa. Results: In case of 474 patients with TURP performed for bladder outlet obstruction, the histopathology findings were the following: 61 cases with newly diagnosed PCa, some in spite of normal PSA values, 23 cases with already hormone treated prostate cancer, while in 50 cases TURP was preceded by prostate biopsy (in 8 cases with increased PSA and several negative biopsies, we could confirm PCa of the peripheral zone of the prostate). Conclusion: TURP remains the elective surgical therapy of the bladder outlet obstruction, caused by BPH and even prostate cancer. Obtaining a greater volume of prostate tissue can help in the detection of prostate cancer in its early stages, especially in the transitional zone.Keywords: prostate cancer, transurethral resection of the prostate, prostate specific antigen, bladder outlet obstruction, transrectal ultrasound guided prostate biopsy